The following piece is part of an article written by Dr. Jay Alberts that addresses your issues. Forced Exercise (FE) is different from Voluntary Exercise (VE). As you can see from the article, FE is not just sitting on a cycle that turns one's legs around at a specific rpm. The patient is an active participant in the exercise. On a tandem the patient provides at least 25% of the power in order to achieve results. From reading the Therapy-Cycle website, it appears that there is a hodgepodge of partial information and data, all designed to part the patient from their $. I have written to Dr. Alberts to ask about the Motomed and will let you know when I hear from him. I hope this helps. I'm eager for Dr. Albert's cycle to be generally available, but I firmly believe that testing, gathering data, and evaluating it are of primary importance.
Here are the parts from his 2011 article:
"FE, in this case, is defined operationally as a mode of aerobic exercise in which exercise rate is augmented mechanically to assist the participant in achieving and maintaining an exercise rate that is greater than their preferred voluntary rate of exercise. It is important to note that during FE, the participant is contributing actively to the exercise; they are not being moved through the motion passively. Our data indicate that FE leads to a global improvement in PD motor function and an alteration in the CNS [Central Nervous System] function (22). These global changes in motor function and altered activation patterns provide strong evidence for the hypothesis that for patients with PD to derive motor benefits from exercise, assistance is required to achieve a rate of exercise that triggers the release of neurotrophic factors or possibly dopamine.
FUTURE DIRECTIONS AND SUMMARY
A randomized controlled trial currently is underway as a follow-up to the initial tandem cycling study. Subjects are randomized to one of three groups: no exercise, VE, and FE. However, in the current trial, a motor-driven cycle, which we have developed is being used to safely deliver FE. A model- based controller was developed to replicate the ‘‘feel’’ of the human interaction that occurs during tandem cycling (e.g., real-time alteration of motor contribution, pedaling rate, and monitoring of heart rate). The controller model approximates the dynamics of the cycle interacting with the rider during an exercise session. This trial includes clinical testing and neuroimaging 8 wk after exercise cessation to help determine the long-term effects of FE and VE in patients with PD. We also are engaged in a preliminary study with deNovo patients with PD in which they will exercise for 6 months in their home. Weekly cognitive and motor assessments will be made and compared with a group of deNovo patients with PD who are not exercising. Collectively, these studies will provide greater information regarding the potential mechanisms underlying any improvements in cognitive or motor function in patients with PD after FE or VE, the possible duration of motor or symptom benefits and initial data regarding the potential for exercise to slow the progression of PD.
Although the exact components and dosage of optimal exercise interventions have not been determined for patients with PD, evidence from the animal studies and our data suggests that intensive aerobic FE may have neurorestorative and neuroprotective properties possibly through the endogenous release of neurotrophins or alteration of dopamine. Animal and our preliminary human data suggest the ability to influence cognition, metabolism, and potentially, the progression of neurodegenerative diseases through these mechanisms. Even the hint of neurorestoration associated with FE warrants the testing of this intervention in other neurologic conditions such as stroke and Alzheimer disease, as the ‘‘side effects’’ of exercise include improved cardiovascular fitness and increased energy. Future studies will help delineate the optimal dosage of FE or VE for neurologic patients. Furthermore, a clearer understanding of the use of FE as a neuroprotective or neurorestorative adjunct to pharmacological or surgical interventions offers these patients a rare opportunity to participate actively in the treatment of their disease with minimal risks or side effects."
Copyright © 2011 by the American College of Sports Medicine